Students' understanding of teamwork and professional roles after interprofessional simulation-a qualitative analysis

Development and implementation of a high-fidelity simulation training course for medical and nursing collaboration based on the Fink integrated course design model

Aim

The purpose of this study is to examine the design and implementation of a high-fidelity simulation training course for medical and nursing collaboration, based on the Fink integrated course design model. Additionally, the study aims to validate the teaching effectiveness of the course.

Background

Previous empirical studies have highlighted the effectiveness of collaborative healthcare education in institutional teaching and hospital training. However, the development of healthcare collaborative education in China has been slow to develop in China. In recent years, Chinese nursing educators and researchers have shown interest in utilizing high-fidelity simulators for healthcare collaborative education. These simulators help address the limitations of traditional nursing teaching and healthcare separation simulation. Nevertheless, a standardized simulation interprofessional education curriculum is still lacking. Therefore, nursing educators need to develop a standardized high-fidelity simulation training curriculum for healthcare collaboration, guided by established science curriculum development theories.

Methods

A high-fidelity simulation training course on healthcare collaboration was designed based on the Fink integrated curriculum design model. The course was taught to 14 nursing students and 8 clinical medicine students from March to July 2022. To comprehensively evaluate the effectiveness of the healthcare collaboration high-fidelity simulation training course, several assessment tools were used. These included course grades, satisfaction and self-confidence scales, simulation teaching practice scales, healthcare collaboration attitude scales, critical thinking skills scales, and semi-structured interviews.

Results

After the course was implemented, students demonstrated high overall scores (79.19 ± 5.12) and reported high satisfaction ratings (4.44 ± 0.37). They also exhibited increased self-confidence (4.16 ± 0.33). Additionally, students evaluated all four dimensions of the course teaching practice scale positively. Furthermore, the study demonstrated significant improvements in various aspects, such as attitudes toward medical and nursing collaboration (t = -7.135, P < 0.01), shared education and teamwork (t = -3.247, P = 0.002), job autonomy for nurses (t = -1.782, P = 0.000), and reduced physician dominance (t = -6.768, P = 0.000). The critical thinking skills of the students showed significant improvement, with higher scores in truth-seeking (t = -3.052, P = 0.004), analytical ability (t = -2.561, P = 0.014), systematic ability (t = -3.491, P = 0.001), self-confidence in critical thinking (t = -4.024, P = 0.000), and curiosity (t = -5.318, P = 0.000) compared to their scores before the course (all P < 0.05). The interviews showed that the course's student-centered approach enabled active learning. Students suggested enhancing teaching cases and allocating more time for reflection and summarization.

Conclusion

The study successfully designed a high-fidelity simulation training course for healthcare collaboration by utilizing the Fink integrated curriculum design model. The findings provide valuable insights for the development of standardized curricula and healthcare collaboration education in China. Moreover, the course adheres to best practice principles, fostering improved attitudes toward healthcare collaboration and enhancing students' healthcare collaboration and clinical thinking skills.

An Exploration of Student Perception Toward Interprofessional High-Fidelity Clinical Simulation

OBJECTIVES

Interprofessional education is recognized for its potential for collaboration and teamwork, reflecting clinical practice; however, existing literature for simulation-based interprofessional education does not include Physician Associate (PA) students. This initiative aimed to explore the students' perception of interprofessional clinical simulation for PA students and allied health professional (AHP) students as part of our program development.

METHODS

A high-fidelity simulation session was designed and conducted for volunteering students from the PA, paramedic science, and physiotherapy courses. We used a mixed-method electronic questionnaire consisting of 15 statements rated on a numerical rating scale (0-5) and four open-ended questions with unlimited free-text responses to explore student perceptions. Inductive thematic analysis was used for qualitative analysis. The session design was underpinned by Allport's (intergroup) contact hypothesis with an emphasis on mutual intergroup differentiation.

RESULTS

Forty-six students participated in the simulation teaching, with 48% (n = 22) providing feedback. Overall student perception was mainly positive toward the interprofessional simulation; however, some barriers to learning were recognized. Based on the evaluation of our initiative and existing literature, we propose 5 top tips to promote an effective learning experience for students. (1) Understand the importance of interprofessional collaboration. (2) Establish clear roles. (3) Plan the scenarios in advance. (4) Maintain equal status between groups. (5) Provide clear instructions and expectations.

CONCLUSION

To our knowledge, this is the first study of high-fidelity interprofessional simulation involving PA and AHP students. We successfully explored student perception which highlighted aspects that can impact learning. This pilot study demonstrated that interprofessional simulation is a feasible and acceptable form of learning for our students and highlighted how to improve future interprofessional simulation teaching sessions.

The learning experiences of student nurses in the perioperative environment: An integrative literature review

OBJECTIVES

For the Student Nurse placement in the perioperative environment provides an opportunity to observe and engage in preoperative, intraoperative, and immediate postoperative care of the surgical patient. To date no synthesis of empirical studies has been undertaken to ascertain the learning impact of the perioperative experience. The objectives of this review were to identify and synthesise the literature on the learning experiences of student nurses within the perioperative environment.

DESIGN

An integrative review that followed Whittemore and Knafl's (2005) framework.

DATA SOURCES

Studies published between 2012 and 2022 were identified via a comprehensive search of the following databases: CINAHL, Medline (OVID), Medline (Pubmed), Medline (EBSCO), EMBASE, PsychINFO, ISI Web of Science and SCOPUS.

REVIEW METHODS

The review was reported in line with the Preferred Reporting for Systematic Reviews and Meta-Analysis (PRISMA). The initial search located 1475 Articles. After screening and checking for eligibility 17 articles were selected. These were critically appraised using the Critical Appraisal Skills Programme (CASP). The papers were analysed and reported in a narrative synthesis.

RESULTS

Seventeen studies met the inclusion criteria for the review. Three categories with five sub categories were identified including: Learning opportunities, Appreciation for perioperative role and intent to return and Factors influencing student learning.

CONCLUSIONS

A large variety of student learning occurs within the perioperative clinical environment. Students viewed staff nurses as positive role models in an environment that posed opportunities and challenges for student learning. Anxiety and stress in an unfamiliar environment were commonly mentioned with students offering recommendations to improve their experience.

How theories of complexity and resilience affect interprofessional simulation-based education: a qualitative analysis of facilitators' perspectives

BACKGROUND

Quality of care and patient safety rely on the ability of interprofessional teams to collaborate effectively. This can be trained through interprofessional simulation-based education (IPSE). Patient safety also relies on the ability to adapt to the complexity of such situations, an ability termed resilience. Since these needs are not explicitly addressed in IPSE, the aim of this study was to explore how central concepts from complexity-theory and resilience affect IPSE, from facilitators' perspective, when applied in debriefings.

METHODS

A set of central concepts in complexity-theory and resilience were introduced to facilitators on an IPSE course for nursing and medical students. In five iterations of focus groups interviews the facilitators discussed their application of these concepts by reviewing video recordings of their own debriefings. Video recordings of the interviews were subjected to coding and thematic analysis.

RESULTS

Three themes were identified. The first, Concepts of complexity and resilience are relevant for IPSE, points to the applicability of these concepts and to the fact that students often need to deviate from prescribed guidelines/algorithms in order to solve cases. The second theme, Exploring complexity, shows how uncertainty could be used as a cue to explore complexity. Further, that individual performance needs to account for the context of actions and how this may lead to certain outcomes. Moreover, it was suggested that several ways to approach a challenge can contribute to important insight in the conditions for teamwork. The third theme, Unpacking how solutions are achieved, turns to needs for handling the aforementioned complexity. It illustrates the importance of addressing self-criticism by highlighting how students were often able to overcome challenges and find solutions. Finally, this theme highlights how pre-defined guidelines and algorithms still work as important resources to help students in transforming perceived messiness into clarity.

CONCLUSIONS

This study suggests that IPSE provides the possibility to explore complexity and highlight resilience so that such capability can be trained and improved. Further studies are needed to develop more concrete ways of using IPSE to account for complexity and developing resilience capacity and to evaluate to what extent IPSE can provide such an effect.

Transforming Professional Identity in Simulation Debriefing: A Systematic Metaethnographic Synthesis of the Simulation Literature

SUMMARY STATEMENT

There continues to be a lack of detailed understanding of how debriefing works and how it enables learning. To further our understanding and simultaneously illuminate current knowledge, a metaethnographic qualitative synthesis was undertaken to address the research question: how are interactions in simulation debriefing related to participant learning? Ten databases were searched (up to November 2020) and 17 articles were selected for inclusion.Initial interpretive synthesis generated 37 new concepts that were further synthesized to produce a new theoretical framework. At the heart of the framework is a concept of reflective work, where participants and faculty recontextualize the simulation experience bidirectionally with clinical reality: a process that facilitates sensemaking. This occurs in a learning milieu where activities such as storytelling, performance evaluation, perspective sharing, agenda setting, and video use are undertaken. The outcome is conceptualization of new future roles, clinical competence, and professional language development-a process of transforming professional identity.

Interprofessional simulation as an enhancement of psychological fidelity: A focus group study of medical and nursing students

Background and Aims

Interprofessional simulation has the potential to enhance the perceived realism of clinical simulation in the education of different healthcare professionals. This study considers how the inclusion of more than one profession in clinical simulation contributes to this psychological fidelity, defined as the subjective perception of the realism of a simulation, and the cues identified by medical and nursing students.

Methods

Eight focus groups were carried out with 27 medical and 18 nursing students in Newcastle and Oxford, UK. These were carried out immediately after students' participation in simulation sessions consisting of three acute scenarios. Focus group discussions encompassed perceptions of the realism of the simulation and of participants' own and other professional groups. Thematic analysis was carried out on transcripts.

Results

The analysis identified features of psychological fidelity that were influenced by the interprofessional element of the simulation. These included overall impressions of realism, and the perceived roles and expectations of doctors and nurses within the simulation. In particular, the presence of the other professional group afforded a more authentic response. Other features varied with the viewpoint of the student groups, in particular the realism of the patient manikin, which held lower psychological fidelity for the nursing students, because it did not allow them to fulfill their perceived role of delivering holistic, relational care.

Conclusion

Recognizing "psychological fidelity" as a subjective response to simulation allows greater consideration of the limitations of fidelity as a designed or engineered property of a simulation. While interprofessional involvement directly enhances psychological fidelity in some ways, potential differences in the views of students from different professional groups should be considered when implementing interprofessional simulation.

Realist review of interprofessional education for health care students: What works for whom and why

Interprofessional education (IPE) programs, are complex, logistically challenging, and can be expensive to deliver, but these matters are offset by the perceived benefits of IPE. There is little clarity regarding how IPE contributes to the desirable development of collaborative practitioners. To guide educators in the design of IPE programs there is a need to understand the elements that promote optimal learning. A realist review was conducted to identify the mechanisms and resources that contribute to IPE outcomes. Four databases were searched until April 2020 for empirical studies describing mandatory IPE for pre-registration medical, nursing and other health professional students. Twelve articles met the inclusion criteria. Two novel learning design elements were identified; interdependence, where there is a need for genuine contribution of skills and knowledge from the professions learning together to successfully complete tasks, and embodiment, where through being immersed in an authentic scenario, learners feel what it is like to work in their professions. Other observations supported previous research findings such as the importance of skilled facilitators to promote interaction and reflection. Interprofessional interventions incorporating these specific learning design features seem likely to enhance the impact of IPE, thus making the best use of limited institutional resources and student time.

Essential Elements of Preregistration Nursing Interprofessional Simulation Training

BACKGROUND

Internationally, interprofessional simulation (IPS) training increasingly is being included in nursing curricula. This systematic review examined the elements of IPS training that prepare nursing students for clinical practice.

METHOD

Five databases (Cumulative Index to Nursing and Allied Health Literature [CINAHL], ProQuest, PubMed, Scopus, and Google Scholar) were searched for articles published from 2000 through 2020. Search terms included interprofessional, interdisciplinary, collaboration, collaborative care, teamwork, undergraduate nursing, and simulation. Thematic analysis of included studies was conducted using Braun and Clarke's (2006) six-phase approach.

RESULTS

Twenty-one studies were included. Five key themes emerged: (1) foster safe learning spaces, (2) realism matters, (3) effective debriefing is essential, (4) communication and teamwork increase patient safety, and (5) learning about scopes of practice and roles enables better care.

CONCLUSION

IPS training provides nursing students with learning opportunities that can fundamentally shape their capacity to work effectively in interprofessional and multi-disciplinary settings. [J Nurs Educ. 2023;62(1):28-35.].

Evaluation of a Multidisciplinary Extracurricular Event Using Kolb's Experiential Learning Theory: A Qualitative Study

Background and Purpose

Although health science programs run parallel to each other and comprise of shared core subjects between the different disciplines, students of the different disciplines rarely mix or interact with each other during their undergraduate studies. Extracurricular activities are a big part of university students' life, through which students have an opportunity to express themselves and enhance their soft skills in a safe and relaxed environment. Recently, King Saud University (KSU), Saudi Arabia, launched a multi-disciplinary event aimed at raising public's awareness of their rights and responsibilities in the healthcare system. Although the event was designed to educate the public about their rights and responsibilities in the healthcare system, it has proven to be a good opportunity to promote interprofessional education among participating students. This study aims to review and assess the impact of this multi-disciplinary public awareness event on the acquisition of core interprofessional competencies by participating students from the health sciences using Kolb's experiential learning theory as a framework.

Patients and Methods

This qualitative study used semi-structured Zoom interviews in Nov 2020 with health science students who participated in the event. The research team used a pre-designed topic guide based on Kolb's experiential learning theory (KELT) for the interview questions. The interviews were recorded, transcribed, coded, and analysed using thematic analysis.

Results

Twenty-one students, representing four health science colleges at KSU participated in three focus groups. The main themes identified were participants' attitudes towards the event, the types of knowledge and skills acquired from the event, and how they practically applied the knowledge acquired. These themes were aligned to KELT as this study's framework.

Conclusion

The event covered the most important concepts of interprofessional education and could be a potential tool to educate students from multiple disciplines.

Best Educational Techniques in High-Fidelity Simulation According to Nursing Students-Adaptation and Validation of the Educational Practices Questionnaire (EPQ)

The purpose of this study was to evaluate the best educational techniques used during high-fidelity simulations in training nursing students and to introduce the Polish version of the Educational Practices Questionnaire (EPQ) scale after its cultural adaptation and determination of its psychometric properties. The research group was composed of 361 second- and third-year nursing students in the licentiate program. The Cronbach's alpha reliability coefficients for the adapted tool were 0.90 for the EPQ-PO (presence of educational techniques) subscale and 0.93 for the EPQ-IO subscale (importance of educational techniques). Additionally, the model fit rates in the CFA and EFA (as indicators of theoretical validity) proved to be high enough for the tool to be successfully used in scientific research. Preliminary results are also presented; the mean value of the response for the entire EPQ scale for both the PO and IO sections was M = 4.3, SD ± 0.90. The students in the study rated the opportunity for collaboration with other students and for working jointly on a given clinical situation very highly at M = 4.5, SD ± 0.70. The analysis of the scores of the individual scales and subscales of the EPQ showed statistically significant differences in results obtained for such variables as gender, place of residence, and year of studies.

Changes in medical students´ and anesthesia technician trainees´ attitudes towards interprofessionality - experience from an interprofessional simulation-based course

BACKGROUND

Interprofessional simulation based education (IPSBE) programs positively impact participants' attitudes towards interprofessional collaboration and learning. However, the extent to which students in different health professions benefit and the underlying reasons for this are subject of ongoing debate.

METHODS

We developed a 14-h IPSBE course with scenarios of critical incidents or emergency cases. Participants were final year medical students (FYMS) and final year anesthesia technician trainees (FYATT). To assess attitudes towards interprofessionalism, the University of the West of England Interprofessional Questionnaire was administrated before and after the course. Using focus group illustration maps, qualitative data were obtained from a subcohort of the participants (n = 15).

RESULTS

After the course, self-assessment of communication and teamwork skills, attitudes towards interprofessional interactions and relationships showed comparative improvement in both professions. Attitudes towards interprofessional learning improved only in FYMS. Qualitative data revealed teamwork, communication, hierarchy and the perception of one's own and other health profession as main topics that might underlie the changes in participants' attitudes. An important factor was that participants got to know each other during the course and understood each other's tasks.

CONCLUSIONS

Since adequate communication and teamwork skills and positive attitudes towards interprofessionality account to effective interprofessional collaboration, our data support intensifying IPSBE in undergraduate health care education.

Interprofessional communication in medical simulation: findings from a scoping review and implications for academic medicine

BACKGROUND

Interprofessional communication is fundamental to the delivery of healthcare and can be taught in medical school and other health professional schools through interprofessional education (IPE) activities. Simulation centers have become a predominant location for simulation IPE activities with infrastructure able to support high fidelity activities in a controlled environment. In this secondary analysis of a scoping review conducted on simulation-based IPE, we describe the characteristics of previously reported simulation IPE activities involving undergraduate medical students in a simulation center focused on interprofessional communication.

METHODS

Electronic searches of PubMed, CINAHL, and ERIC databases in accordance with PRISMA-ScR guidelines were conducted to isolate relevant articles from 2016-2020. In total, 165 peer-reviewed articles met inclusion criteria and data extraction linked to four research questions was applied by one individual and the accuracy was confirmed by a second individual. A secondary analysis was performed to describe what existing approaches for simulation IPE in simulation center settings have been used to explicitly achieve interprofessional communication competencies in undergraduate medical education. A sub-dataset was developed from the original scoping review and identified 21 studies describing simulation IPE activities that took place in dedicated simulation centers, targeted the IPEC interprofessional communication domain, and involved undergraduate medical students.

RESULTS

Though diverse, the majority of simulation IPE activities described high-fidelity approaches involving standardized patients and utilized assessment tools with established validity evidence in IPE activities to measure learning outcomes. A minority of simulation IPE activities were described as hybrid and utilized more than one resource or equipment for the activity and only two were longitudinal in nature. Learning outcomes were focused predominantly on modification of attitudes/perceptions and few targeted higher levels of assessment.

CONCLUSIONS

Educators charged with developing simulation IPE activities for medical students focused on interprofessional communication should incorporate assessment tools that have validity evidence from similar activities, target higher level learning outcomes, and leverage hybrid models to develop longitudinal simulation IPE activities. Though an ideal environment to achieve higher level learning outcomes, simulation centers are not required for meaningful simulation IPE activities.

A preliminary simulation-based qualitative study of healthcare students’ experiences of interprofessional primary care scenarios

Background

Introducing interprofessional education (IPE) in healthcare curricula can prepare students for healthcare practices that have become increasingly complex. The use of simulation is promoted to support IPE. This study explores healthcare students’ experiences of participating in common, sub-acute patient scenarios that routinely occur in clinical practice in primary care. More specifically, it looks at how sub-acute patient scenarios from primary care can help develop interprofessional collaborative competence.

Methods

Medical students (N = 10), master’s students in advanced geriatric nursing (N = 8) and bachelor’s students in nursing (N = 9) participated in the simulations. The students were in their last or second-to-last year of education. We conducted five semi-structured focus group interviews with the participants’ directly after the simulation training to elicit experiences related to the scenarios, the simulation and interprofessional collaboration. The transcripts were analysed using systematic text condensation. To supplement the focus group interviews, the students also completed the interprofessional collaborative competency attainment survey (ICCAS), which measures the students’ self-assessed interprofessional competence.

Results

Three main themes emerged from the analysis of the focus group interviews: realism, uncertainty and reflection. The students emphasised the importance of authentic and recognisable scenarios. They said the vague and unspecific patient symptoms created uncertainty in the situation, making it difficult to understand the patient’s diagnosis. Despite that uncertainty, they described the experience as positive. Further, the students expressed that the simulation increased their confidence in interprofessional collaboration and prepared them for future work. The results from the ICCAS questionnaire showed that the students reported a subjective positive change in their interprofessional competence after participating in the scenarios.

Conclusions

This study showed that simulation-based IPE with sub-acute primary care scenarios contributes to develop interprofessional collaborative competence in healthcare education. Sub-acute scenarios can supplement the more common approaches with acute care scenarios and aid in developing the collaborative competence required to work in healthcare teams.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41077-022-00204-5.

RETRACTED: International nursing students' perceptions and experiences of transition to the nursing workforce - A cross-sectional survey

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/locate/withdrawalpolicy). This article has been retracted at the request of the authors because the data reported in the manuscript are likely to have been compromised. It came to the co-authors’ attention after the publication of the article that a large proportion of the surveys reported in the study had been completed by a respondent using the first author’s IP addresses. The authors would like to apologize to readers for this error.

Undergraduate nursing students' self-reported professional behaviour at the University of Namibia

Background

Development of professional behaviour in nursing students is an important part of a nurse’s overall competence. Self-evaluation is one way of measuring professional behaviour amongst nursing students. However, studies on self-reported professional behaviour of nursing students are limited in Namibia.

Aim

This study aimed to investigate nursing students’ self-reported professional behaviour at the University of Namibia.

Setting

The setting was a university campus offering a Bachelor of Nursing Science degree in Namibia.

Methods

A quantitative descriptive contextual design was used with 100 nursing students. Data were analysed descriptively using a non-parametric Kruskal–Wallis and ANOVA tests of variance and statistical significance.

Results

High mean scores were found in the areas of utilising evidence-based solutions (4.78 ± 0.58), promoting clinical teaching (4.46 ± 0.94), willingness to implement quality improvement initiatives (4.34 ± 0.518), and protecting health, safety and patient’s rights (4.28 ± 0.55). The lowest mean scores were recorded in projecting professional image (2.22 ± 1.27), rendering evidence-based care (4.08 ± 0.44). The study found statistical significance difference between self-reported professional competency (p = 0.01) and quality care improvements (p = 0.02).

Conclusion

In this study, nursing students’ self-reported professional behaviour was rated high (mean scores > 4.0 out of 5). Despite this high rating, it cannot be concluded that the students were professionally competent. We recommend that professional behaviour be measured from both students’ and nurse educators’ or patients’ perspectives.

Contribution

The findings from this study provide supplementary evidence on self-reported professional behaviour with implications on nursing education and practice.

Leveraging Podcasts to Introduce Medical Students to the Broader Community of Health Care Professionals

INTRODUCTION

Safe, patient-centered, and cost-effective care requires effective collaboration within interprofessional teams. Education programs for health care professionals are often siloed, providing students with limited interprofessional education (IPE) opportunities to learn from, with, and about other professions. Podcasts offer a novel approach to facilitate IPE, allowing for asynchronous conversations with interprofessional colleagues.

METHODS

We developed four podcasts with various health care professionals for 135 preclinical medical students preparing to transition into clinical rotations. The podcasts were coupled with an hour-long interactive session with the podcast interviewees conducted via videoconference. The curriculum explored the distinct education paths, roles, and responsibilities of various health care disciplines. Strategies for communicating effectively with and learning from interprofessional team members were emphasized.

RESULTS

There were 197 unique downloads of the podcasts, and 95 students attended the interactive session. Most students reported that the podcasts and follow-up live session enhanced their learning (100% and 98% of students who completed the postcurriculum survey, respectively). Responses to the postcurriculum survey revealed students learned strategies for engaging in productive interprofessional conversations, the importance of leveraging the distinct roles and responsibilities of diverse health professionals, the value of learning from other health professionals, and the use of respectful language.

DISCUSSION

This IPE curriculum built around podcasts enhances medical student learning and represents an innovative approach to improving access to IPE in a virtual learning environment. This modality can be adapted to meet the needs of a wide spectrum of learners and can be coupled with in-person learning.

Exploring healthcare students' interprofessional teamwork in primary care simulation scenarios: collaboration to create a shared treatment plan

BACKGROUND

Primary care providers assume responsibility for patients with increasingly complex problems requiring interprofessional collaboration. Introducing interprofessional education in healthcare curricula prepares healthcare students for this reality. Solving simulation scenarios as an educational strategy is promoted to support interprofessional education in health care, and is mostly used in acute clinical situations. This paper aims to explore how healthcare students' actions influence interprofessional collaboration and treatment plan identification when they solve common, sub-acute patient scenarios in primary care situations.

METHODS

Interaction analysis of video recordings from the simulation scenarios was performed with a focus on the students' joint actions; specifically how these actions unfold and how productive the students were in terms of developing treatment plans.

RESULTS

We found variation in the groups' interactions, the paths they followed, and the quality of their knowledge output in their shared treatment plan. The groups with the capacity to collaborate and engage in sharing information, and explain and elaborate on concepts, were more successful in developing comprehensive treatment plans. Furthermore, these groups managed the duality of defining and solving the immediate problem and collaboratively preparing for future care.

CONCLUSIONS

Analysis of the activities in our scenarios showed the students' potential to practice interprofessional collaboration. Our study illustrates that simulation of sub-acute scenarios in primary care is an underexplored but suitable arena to train communication and teamwork in complex situations. The simulation scenarios are also feasible for use on-site in an educational facility or in practice with minimal equipment and resources.

Developing teamwork skills in baccalaureate nursing students: impact of TeamSTEPPS® training and simulation

OBJECTIVES

Examine the impact of TeamSTEPPS^® training and simulation experiences on student knowledge and teamwork attitudes in a baccalaureate-nursing program.

METHODS

This study used a quasi-experimental, pre-test, post-test design. The intervention included a workshop followed by 2 days of simulation experiences. Participants included a total of 46 nursing students. Instruments included the TeamSTEPPS learning benchmark and the Teamwork Attitudes Questionnaire (T-TAQ).

RESULTS

Scores on the learning benchmark increased following the intervention. In addition, changes in subscores of teamwork strategies, leadership, situation monitoring, and mutual support on the T-TAQ indicate an improvement in student attitudes toward teamwork.

CONCLUSIONS

Incorporating TeamSTEPPS^® strategies into undergraduate education can be effective in increasing student knowledge and improving attitudes toward interdisciplinary teamwork.

Staff Perspectives of Mass Casualty Incident Preparedness

Introduction Mass casualty incidents (MCI) are low-frequency, high-risk events that disrupt the day-to-day operations of medical centers. Day-to-day protocols are insufficient for effectively managing MCI events, creating a need to develop and test MCI-specific protocols. The aim of this project was to utilize interviews to gain insight into staff experience and perspective on MCIs and their institution's response plans. Methods Staff members who participated in an MCI drill were asked semi-structured interview questions regarding their perspectives on their current priorities, the information needed to perform their role, and their greatest concerns about an MCI. This quality improvement (QI) project utilized a qualitative methodology to thematically organize the results of the staff responses. Results A total of 64 staff members with various levels of patient care experience were interviewed to reach thematic saturation. The use of staff interviews helped to identify the four primary themes that emerged, which were: 1) process, 2) supplies and resources, 3) communication, and 4) roles. Furthermore, each theme also included a number of subthemes. Conclusions This project demonstrated the importance of staff experiences related to MCI simulation training and preparedness, which may be useful for future training and emergency response planning. Additionally, the results may be helpful for other institutions when building a robust MCI simulation training program or designing an emergency response plan.

Pre-registration nursing and occupational therapy students' experience of interprofessional simulation training designed to develop communication and team-work skills: A mixed methods study

To bridge the gap between university and the clinical environment, the university where this study was conducted incorporated interprofessional simulation sessions into the curricula for pre-registration nursing and occupational therapy students. The purpose of the study was to evaluate the effectiveness of simulation training to support the development of students' interprofessional communication and teamwork skills. Study participants were first-year students. A mixed methods study design was used that included: (1) a cross-sectional survey, (using the Interprofessional Education Collaborative Competency Self-Assessment tool), before and after the simulation session; and (2) two focus groups with students and one with academic staff. A total of 91 students and 5 staff participated. All students increased their self-perceived skills in interprofessional interactions. Two major themes were identified: 'Communication and Teamwork', with four sub-themes, (1) 'Significance of Communication in teamwork'; (2) 'Learning about, from and with each other'; (3) 'Professional role identification and collaborative practice'; and (4) 'Clinical leadership facilitated collaboration' and 'Lessons learnt from the simulation session', with three subthemes: (1) 'enhanced preparation for clinical placement'; (2) 'the experience of interacting with a simulated patient'; and (3) 'holistic patient care'. The results from the study demonstrated that interprofessional simulation sessions are an effective approach to introducing and developing collaborative clinical practice.

Has "The Ceiling" Rendered the Readiness for Interprofessional Learning Scale (RIPLS) Outdated?

PURPOSE

The present study aimed to investigate the preliminary effects of collaborative learning and simulation on readiness to engage in and attitudes toward future interprofessional learning activities. We translated into Norwegian and validated the original Readiness for Interprofessional Learning Scale (RIPLS) (part 1) to measure the efficacy and feasibility of a structured collaborative learning activity (part 2).

MATERIALS AND METHODS

Undergraduate social and health care professional students from five Norwegian universities (n = 307) participated in the validation stage of this study (part 1). A Norwegian version of the RIPLS was developed using forward and backward translation. An expert panel discussed discrepancies between the translations and professional concepts. We planned to conduct a principal component analysis to evaluate the structure, reliability, and internal consistency of the Norwegian version of the RIPLS, after investigating the skewness, kurtosis, and range of items included. One hundred fifty students participated in collaborative learning activities; 72 (48%) of these individuals answered the translated RIPLS questionnaire.

RESULTS

We found a substantial ceiling effect in the majority of items in the RIPLS, making it difficult to use the instrument as a measure of change. We evaluated the efficacy and feasibility of the collaborative activities based on the changes in the single items that had sufficient univariate normality and ultimately confirmed positive changes in two of these items.

CONCLUSION

Norwegian students appear ready for interprofessional learning; however, due to significant ceiling effects, the majority of items in the RIPLS no longer seem suitable for measuring and evaluating the effects of interprofessional learning (part 1). Single-item analysis revealed a potential effect of collaborative learning (part 2). A new questionnaire is needed where readiness is instead understood as self-efficacy in areas such as role awareness and interprofessional communication. Researchers should be aware that even previously validated questionnaires may lose their applicability over time and require revision. Demands for interprofessional learning and practice are continuously evolving, and evaluation methods should be adjusted accordingly.

Perceptions of interdisciplinary education and readiness for inter-professional education of nursing students: A sample of three different cities in Turkey

BACKGROUND

In recent years, interprofessional education has been described as an opportunity for all healthcare professionals to enhance nursing quality by learning together and about one another. Determining perceptions and readiness of nurses regarding interprofessional education is important for effective education planning.

OBJECTIVES

The aim of the study is to determine readiness for interprofessional learning and perceptions of interdisciplinary education of nursing students.

DESIGN

Descriptive and cross-sectional study.

SETTINGS

Nursing departments of public universities, in three different cities in Turkey.

METHODS

This study was conducted with 738 third- and fourth-year nursing students. The data of the study was collected using "Student Information Form", "Readiness for Inter-professional Learning Scale (RIPLS)", and "Interdisciplinary Education Perception Scale (IEPS)". The data was analyzed using descriptive statistics, Student's t-test, Kruskal-Wallis test, one-way analysis of variance (ANOVA), and correlation.

RESULTS

Mean age of the students was 21.56 ± 1.48, and the majority (72.9%) were women. Of the students, 58.9% chose their profession willingly, 56% chose the department as their first choice, 41.2% wanted to receive education with other healthcare students, and 84% reported having prior teamwork experience. Students' mean total scores of RIPLS and IEPS were respectively 69.78 ± 11.32 and 69.19 ± 16.62. There was a statistically significant difference between RIPLS mean scores and choosing the occupation willingly, order of choice, being satisfied with the choice of department, and willingness to study with other healthcare students, and between IEPS mean scores and choosing the occupation willingly, order of choice and being satisfied with the department choice (p < 0.05).

CONCLUSION

Nursing students in three different cities had good readiness levels for interprofessional education and perception levels of interdisciplinary education, and differed according to certain demographical qualities. In addition, there was a positive relationship between readiness of inter-professional education, and perceptions of the students.

Nursing and medical students' perceptions of an interprofessional simulation-based education: a qualitative descriptive study

PURPOSE

The purposes of this study were to describe the development and implementation of an interprofessional simulation-based education (IPSE) for undergraduate nursing and medical students, their perceptions of the impact of IPSE, and identify their changes in attitudes toward each other's health professions after participating in IPSE in South Korea.

METHODS

This study used a qualitative descriptive design. A purposive sample of 43 third-year medical students and a convenient sample of 44 fourth-year nursing students participated in a 2-day IPSE program that consisted of ice-breaking and patient safety activities, and 4-hour three interprofessional team-based high-fidelity simulation education sessions. Data were collected through reflective journal after the IPSE program and keywords before and after the IPSE program, and were analyzed using the content analysis and word cloud analysis.

RESULTS

Three themes emerged: "positive experience" with understanding roles and responsibilities and learning by doing in simulation environments being reported. In the second theme, "positive learning outcomes" participants reported enhancing collaboration and confidence in communication skills. The final theme "benefits to patients of interprofessional collaborative practice" included high quality of care and patient safety. Before the IPSE experience, most medical students perceived the nurse as nightingale and syringe, and nursing students perceived the doctor as order, expert, and knowledge. After their IPSE experience, both nursing and medical students viewed each other as colleagues.

CONCLUSION

These results suggest that the use of high-fidelity team-based simulation in IPE is effective in practicing and developing undergraduate nursing and medical students' interprofessional collaboration through hands-on experience.

Evolution of an obstetrics and gynecology interprofessional simulation-based education session for medical and nursing students

Simulation and Objective Structured Clinical Examination assessment of learners can teach clinical skills proficiency in a safe environment without risk to patients. Interprofessional simulation-based education (IPSE) contributes to a transformation in students' understanding of teamwork and professional roles. Long term outcomes for stimulation and IPSE sessions, are less well studied. We hypothesized that a progressive interprofessional education simulation program incorporating both faculty and interprofessional student collaboration would improve medical students' knowledge retention, comfort with procedural skills, positive teamwork and respectful interaction between students.An Obstetrics and Gynecology IPSE for medical and nursing students (NS) was developed in collaboration between a school of medicine and a school of nursing from 2014 to 2017. By 2017, content includedFrom 2014 to 2016, medical students completed attitude, knowledge, and perception surveys both pre and immediately post simulation, at 4 months, and 8 months. In 2017; all students completed self-assessments and received faculty-assessments.The program trained 443 medical and 136 NS. Medical students' knowledge, comfort, and interest increased significantly post simulation. Outcome scores decreased but were still significantly improved at 4 months but nearly dissipated by 8 months. There were no significant differences between medical and NS self-assessment or faculty-assessment scores regarding IUD insertion, cervical examination, or contraception quiz scores. Medical students' birth simulation self-assessment versus faculty-assessment scores were 8.6 vs 8.9, P < .001.Simulation improved students' short-term medical knowledge, comfort, and perception with some long-term persistence at 4-8 months. Medical and NS learned obstetrics and gynecology skills in a collaborative environment and in role-specific situations. Medical students had the opportunity to learn from NS. Positive teamwork and respectful interaction occurred between the students.

Interprofessional communication (IPC) for medical students: a scoping review

BACKGROUND

Effective Interprofessional Communication (IPC) between healthcare professionals enhances teamwork and improves patient care. Yet IPC training remains poorly structured in medical schools. To address this gap, a scoping review is proposed to study current IPC training approaches in medical schools.

METHODS

Krishna's Systematic Evidence Based Approach (SEBA) was used to guide a scoping review of IPC training for medical students published between 1 January 2000 to 31 December 2018 in PubMed, ScienceDirect, JSTOR, Google Scholar, ERIC, Embase, Scopus and PsycINFO. The data accrued was independently analysed using thematic and content analysis to enhance the reproducibility and transparency of this SEBA guided review.

RESULTS

17,809 titles and abstracts were found, 250 full-text articles were reviewed and 73 full text articles were included. Directed Content analysis revealed 4 categories corresponding to the levels of the Miller's Pyramid whilst thematic analysis revealed 5 themes including the indications, stages of trainings and evaluations, content, challenges and outcomes of IPC training. Many longitudinal programs were designed around the levels of Miller's Pyramid.

CONCLUSION

IPC training is a stage-wise, competency-based learning process that pivots on a learner-centric spiralled curriculum. Progress from one stage to the next requires attainment of the particular competencies within each stage of the training process. Whilst further studies into the dynamics of IPC interactions, assessment methods and structuring of these programs are required, we forward an evidenced based framework to guide design of future IPC programs.

Nurse Practitioner and Medical Students' Perceptions of Teamwork Before and After a Standardized Patient Pilot Simulation

Attitudes toward interprofessional education are positive overall, but inferences about its key elements are hard to draw. Studies with qualitative strands examining interprofessional education's key elements (communication, collaboration/teamwork, learning in practice, and understanding of roles) are especially needed. This mixed quantitative/qualitative standardized patient simulation involved 10 family nurse practitioner and 10 medical students. Both cohorts expressed improved teamwork confidence but were concerned about the complexity of teamwork and pressures on communication. At the complexity/communication nexus, nurse practitioner students thought interprofessional trust and equality were key; medical students saw the importance of strategizing multiple professional perspectives.

Graduate level health professions education: how do previous work experiences influence perspectives about interprofessional collaboration?

Understanding how previous experiences with interprofessional education and collaboration inform health care provider perspectives is important for developing interprofessional interventions at the graduate level. The purpose of this study was to examine how previous work experiences of graduate level health professions students inform perspectives about interprofessional education and collaboration. Drawing from program evaluation data of two separate graduate level interprofessional education interventions based in primary care and home health care, we conducted a qualitative secondary data analysis of 75 interviews generated by focus groups and individual interviews with graduate students from 4 health professions cadres. Using directed content analysis, the team coded to capture descriptions of interprofessional education or collaboration generated from participants' previous work experiences. Coding revealed 173 discrete descriptions related to previous experiences of interprofessional education or collaboration. Three themes were identified from the analysis that informed participant perspectives: Previous educational experiences (including work-based training); previous work experiences; and organizational factors and interprofessional collaboration. Experiences varied little between professions except when aspects of professional training created unique circumstances. The study reveals important differences between graduate and undergraduate learners in health professions programs that can inform interprofessional education and collaboration intervention design.

Rubric-based debriefing to enhance nursing students' critical thinking via simulation

Introduction

Debriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning.

Objectives

We evaluated the effects of rubric-based debriefing on students' critical thinking, level of confidence in performing tasks and communication.

Method

This is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question.

Results

Based on generalised estimating equation models, the intervention effect over time was found to be statistically significant (β=2.06, 95% CI 1.04 to 3.08) in enhancing students' critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities.

Conclusions

This is the first study to provide evidence that a rubric-based debriefing enhances students' critical thinking in simulation learning.

Senior nursing student's perceptions of an interprofessional simulation-based education (IPSE): A qualitative study

Purpose

The purpose of this study was to explore the perceptions and attitudes toward interprofessional simulation-based education among Lebanese senior nursing students.

Methods

The study used an exploratory descriptive qualitative approach and collected data through focus groups. All focus group discussions were audiotaped, transcribed verbatim, and narratives were compared with the recordings to establish accuracy, credibility and reliability of data. Qualitative narratives were translated to English and analyzed through an inductive thematic content analysis. This study was reported according to the Standards for Reporting Qualitative Research (SRQR).

Results

Four major themes were identified: understanding roles and responsibilities, enhancing collaboration, improve personal and interpersonal skills, and patient outcomes.

Conclusion

The senior nursing students showed a positive perception and attitude toward interprofessional simulation-based education. They found that interprofessional simulation-based education increased their knowledge and understanding of the importance of the roles of other professions, as well as their own role in providing patient care. Furthermore, they perceived that interprofessional simulation-based education improved their personal and interpersonal skills. These positive findings may contribute to their future success in an interprofessional team, which could lead to improved patient outcomes. Therefore, future research is needed to see how the reported benefits of interprofessional simulation-based education training are reflected in clinical practice and related to patient outcomes.

Using in situ simulation to improve care of the acutely ill patient by enhancing interprofessional working: a qualitative proof of concept study in primary care in England

OBJECTIVE

Acutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants' reported experiences.

SETTING

Three research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.

METHODS

The intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.

RESULTS

The in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.

CONCLUSIONS

This study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.

Shared learning from national to international contexts: a research and innovation collaboration to enhance education for patient safety

BACKGROUND

Patient safety is key for healthcare across the world and education is critical in improving practice. We drew on existing links to develop the Shared LearnIng from Practice to improve Patient Safety (SLIPPS) group. The group incorporates expertise in education, research, healthcare, healthcare organisation and computing from Norway, Spain, Italy, the UK and Finland. In 2016 we received co-funding from the Erasmus + programme of the European Union for a 3-year project.

AIM

SLIPPS aims to develop a tool to gather learning events related to patient safety from students in each country, and to use these both for further research to understand practice, and to develop educational activities (virtual seminars, simulation scenarios and a game premise).

STUDY OUTLINE

The SLIPPS project is well underway. It is underpinned by three main theoretical bodies of work: the notion of diverse knowledge contexts existing in academia, practice and at an organisational level; the theory of reflective practice; and experiential learning theory. The project is based on recognition of the unique position of students as they navigate between contexts, experience and reflect on important learning events related to patient safety. To date, we have undertaken the development of the SLIPPS Learning Event Recording Tool (SLERT) and have begun to gather event descriptions and reflections.

CONCLUSIONS

Key to the ongoing success of SLIPPS are relationships and reciprocal openness to view things from diverse perspectives and cultures.

Interprofessional simulation in undergraduate nursing program: An integrative review

OBJECTIVES

Interprofessional (IP) competencies are critical for successful collaborative practice. Nurse education, through interprofessional simulation, plays a critical role in preparing nursing students achieve these competencies. Although considerable research has been conducted on this topic, a broader perspective is lacking. This review systematically appraised and synthesized evidence examining the effects of interprofessional simulation on nursing students' outcomes.

DESIGN

An integrative review method guided this review.

DATA SOURCES

Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO, and MEDLINE) were searched to locate articles published from 2010 onwards. Search and MeSH terms included: interprofessional, interdisciplinary, simulation, nurse education, nursing, and student. Thirty (30) articles were included in this review.

RESULTS

Findings of content analysis revealed five essential themes: interprofessional communication, appreciation of interprofessional team roles, interprofessional teamwork or collaboration, self-confidence or self-efficacy, and positive attitudes or readiness toward interprofessional learning.

CONCLUSIONS

This review provides a current state of knowledge on the efficacy of interprofessional simulation in enhancing interprofessional learning and competencies in nursing students. However, more research should be done utilizing a more robust method of research and reliable assessment methods. Through interprofessional simulation experiences, nurse academe can adequately prepare nursing students for future collaborative practice. Inclusions of interprofessional simulation activities in all clinical nursing courses can help prepare nursing students achieve inter-professional learning.

Value of Collaboration With Standardized Patients and Patient Facilitators in Enhancing Reflection During the Process of Building a Simulation

INTRODUCTION

We previously reported that experienced clinicians find the process of collectively building and participating in simulations provide (1) a unique reflective opportunity; (2) a venue to identify different perspectives through discussion and action in a group; and (3) a safe environment for learning. No studies have assessed the value of collaborating with standardized patients (SPs) and patient facilitators (PFs) in the process. In this work, we describe this collaboration in building a simulation and the key elements that facilitate reflection.

METHODS

Three simulation scenarios surrounding communication were built by teams of clinicians, a PF, and SPs. Six build sessions were audio recorded, transcribed, and thematically analyzed through an iterative process to (1) describe the steps of building a simulation scenario and (2) identify the key elements involved in the collaboration.

RESULTS

The five main steps to build a simulation scenario were (1) storytelling and reflection; (2) defining objectives and brainstorming ideas; (3) building a stem and creating a template; (4) refining the scenario with feedback from SPs; and (5) mock run-throughs with follow-up discussion. During these steps, the PF shared personal insights, challenging participants to reflect deeper to better understand and consider the patient's perspective. The SPs provided unique outside perspective to the group. In addition, the interaction between the SPs and the PF helped refine character roles.

DISCUSSION

A collaborative approach incorporating feedback from PFs and SPs to create a simulation scenario is a valuable method to enhance reflective practice for clinicians.